Kevin Lee Fujimoto, PSY.D.
Individual provider Active NPI Clinical Psychologist · Kaneohe, HI
NPI 1740329036 · NPPES record last updated Mar 23, 2009
Key facts
- NPI
- 1740329036
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY861 (HI)
- Practice address
- 45-955 Kamehameha Hwy
Suite 206
Kaneohe, HI 96744-3222 - Phone
- (808) 218-8733
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2019 through Oct 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY861 | HI | MD | Clinical Psychologist |
| 19525 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kevin Lee Fujimoto, Pys.D., Inc. | Clinical | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY861 | HI | Yes |
Addresses
Primary practice location
45-955 Kamehameha Hwy
Suite 206
Kaneohe, HI 96744-3222
Mailing address
45-955 Kamehameha Hwy
Suite 206
Kaneohe, HI 96744-3222
Phone (808) 218-8733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A0247641 | Other | HI | HMSA PROVIDER # |
Other providers in Kaneohe, HI
- Colleen M Fox
- Charlotte Ann Freeman
- Fresenius Medical Care Oahu LLC
- Francesca M. Freund
- Douglas Frisbie
- Patrick Fujimoto
- Lia Fukada
- Joan Hanae Fukumoto
- Alana Fuller-Tanaka
- Lincoln Aketomo Furuya
All providers in Kaneohe, HI · Clinical Psychologist in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.